依西美坦治疗绝经后妇女乳腺癌疗效的系统评价

目的系统评价依西美坦治疗绝经后妇女乳腺癌的疗效。方法计算机检索Cochrane图书馆、PubMed、CNKI及CBMdisc等数据库,按既定标准纳入依西美坦治疗绝经后妇女乳腺癌的随机对照试验,以Cochrane系统评价方法逐篇进行质量评价、资料提取,并采用RevMan5.0软件进行统计分析。结果共纳入12个随机对照试验,合计6166例患者。Meta分析结果显示：①在术后辅助内分泌治疗中,依西美坦在增加患者远期无病生存率方面优于他莫昔芬;②在复发或转移的解救治疗中,依西美坦在近期肿瘤客观反应率方面优于他莫昔芬,而与来曲唑、阿那曲唑的近期疗效相当;在远期疗效方面,依西美坦与他莫昔芬相当;③在术前新辅助内分泌治疗中,依西美坦与来曲唑疗效相当。因相关研究太少,该论证力不强。结论现有证据表明,依西美坦用于治疗绝经后妇女乳腺癌显示出一定的近期疗效,但其远期疗效有待进一步研究,有必要开展更多高质量、大样本的随机对照试验以提供更可靠的证据。

Exemestane in the Treatment of Postmenopausal Women with Breast Cancer: A Systematic Review

Objective To assess the effectiveness of exemestane in the treatment of postmenopausal women with breast cancer. Methods We searched The Cochrane Library, PubMed, CBMdisc, and CNKI to identify randomized controlled trials （RCTs） that met the inclusion and exclusion criteria. Two reviewers extracted the data and evaluated the quality of included trials, respectively. Meta-analysis was performed using RevMan 5.0 software. Results A total of 12 RCTs involving 6 166 participants were included, and the results of meta-analyses showed that： （1） When used in neoadiuvant endocrine therapy after operation, exemestane was more effective in progression-free survival than tamoxifen; （2） When used in rescue therapy, exemestane was more effective in obiective response t.han tamoxifen, but not more effective than letrozole or anastrozole; （3） When used in new neoadjuvant endocrine therapy before operation, exemestane was not more effective than letrozole, and there was too little research about it. Conclusions The current evidence shows that exemestane has certain short-term therapeutic effect, but its long-term therapeutic effect is unknown. More high-quality clinical trials are expected for further study.